Fluid resuscitation is widely used in the management of critically ill patients. There are a variety of different fluids available to doctors but there is little evidence regarding how effective they are. One of the most commonly used fluids, a hydroxyethyl starch was recently approved by the TGA for use in Australia. This project aims to compare how effective and safe this fluid is compared to another widely used fluid, saline, for resuscitation of critically ill patients in intensive care.
I am an intensive care clinician who performs clinical trials and experimental large animal research in multiple aspects of acute and intensive care medicine
A Randomised Controlled Trial Of The Effect Of Hydrocortisone On Mortality In Critically Ill Patients With Septic Shock
Funder
National Health and Medical Research Council
Funding Amount
$3,432,452.00
Summary
This study performed across Australia and New Zealand will evaluate whether hydrocortisone, a cheap drug when administered to critically ill patients with severe infection, will save lives.
I am an intensive care physician, clinician and researcher, interested in studying new therapies to improve outcomes in patienst with acute trauma, sepsis and lung injury. A main focus is independent phase 111 clinical trials in critically ill patients
Hypertonic Saline (HTS) In Head Injured Patients - A Multicentre, Prehospital, Prospective Randomised Clinical Trial
Funder
National Health and Medical Research Council
Funding Amount
$247,269.00
Summary
Head injury is common in patients with major trauma, many of whom are young adults. The extent of head injury has a major influence on patient outcome. Low blood pressure after trauma worsens the extent of brain injury by decreasing its blood supply at a critical stage. Much of this secondary brain injury occurs before the patient reaches hospital. Hypertonic saline (HTS) is an intravenous salt solution which has been used in intensive care patients for many years to decrease brain swelling in h ....Head injury is common in patients with major trauma, many of whom are young adults. The extent of head injury has a major influence on patient outcome. Low blood pressure after trauma worsens the extent of brain injury by decreasing its blood supply at a critical stage. Much of this secondary brain injury occurs before the patient reaches hospital. Hypertonic saline (HTS) is an intravenous salt solution which has been used in intensive care patients for many years to decrease brain swelling in head injured patients. We know that HTS can be given to patients before they reach hospital, is safe, and acts by rapidly increasing blood pressure and decreasing brain swelling. Accordingly HTS may minimise secondary brain injury and lead to increased survival. Importantly, HTS is likely to dramatically improve neurological function of survivors without any significant risk of side effects. This study is designed to determine the effectiveness of prehospital HTS in head injured trauma patients with traumatic coma and low blood pressure.Read moreRead less
Early Parenteral Nutrition Vs. Standard Care In The Critically Ill Patient: A Level I Randomised Controlled Trial.
Funder
National Health and Medical Research Council
Funding Amount
$1,852,333.00
Summary
Nutritional support is accepted as a standard of care for the hospitalised patient however there is little agreement as to how it should be provided to the critically ill patient. Despite the fact that studies consistently link malnutrition to worse outcomes, the provision of nutritional support to the critically ill patient is highly variable. Although there is general agreement that it is best to feed critically ill patients via the gastrointestinal tract (stomach tube feeding), there is no ge ....Nutritional support is accepted as a standard of care for the hospitalised patient however there is little agreement as to how it should be provided to the critically ill patient. Despite the fact that studies consistently link malnutrition to worse outcomes, the provision of nutritional support to the critically ill patient is highly variable. Although there is general agreement that it is best to feed critically ill patients via the gastrointestinal tract (stomach tube feeding), there is no general agreement as to when intravenous artificial nutrition should be begun if a patient cannot tolerate a feeding tube. A recent systematic review of all available clinical trials suggests that if a critically ill patient cannot be fed by a stomach tube for at least 24 hours, they may benefit from intravenous artificial nutrition. This is not what currently happens under standard care. The purpose of this multi-centre randomised controlled trial is to determine if early intravenous nutrition saves lives. Because of the cost, and possible risk of increased infections, a study of this type is required before early intravenous nutrition could become a routine therapy in Australia. Informed consent to participate in the study will be obtained from next of kin, or directly from the patient themselves. The study will be managed at the Royal North Shore Hospital, University of Sydney and will include 26 collaborating ANZ hospitals over 18 months.Read moreRead less
Treatment Of Invasively Ventilated Adults With Early Activity And Mobilisation
Funder
National Health and Medical Research Council
Funding Amount
$1,467,137.00
Summary
The sickest patients in intensive care units (ICUs) receive prolonged, invasive support for their breathing. This is currently managed with complete bed rest, and results in severe muscle weakness, increased duration of hospital stay and poor recovery. We have found that early activity and mobilisation during invasive breathing support is safe and may improve survival and recovery. We will test early activity and mobilisation in a large randomised controlled trial of 750 ICU patients.
A Randomised, Placebo-controlled Trial Of Erythropoietin In ICU Patients With Traumatic Brain Injury
Funder
National Health and Medical Research Council
Funding Amount
$1,950,735.00
Summary
Patients who suffer a moderate or severe head injury (traumatic brain injury) have a 50% chance of having a long term neurological disability or death. Erythropoietin is a medication which encourages red blood cell formation but its other beneficial effects are likely to improve outcomes after traumatic brain injury. This study will examine the safety and effects of erythropoietin on long term neurological function in patients who have suffered a traumatic brain injury.
STandaRd Issue TrANsfusion VersuS Fresher Red Blood Cell Use In IntenSive CarE (TRANSFUSE) – A Randomised Controlled Trial.
Funder
National Health and Medical Research Council
Funding Amount
$2,890,335.00
Summary
In Australia, blood for transfusions has a “use by” date of 42 days after collection. The actual age of blood given to patients depends on what is available at the time and the rate of usage. Some research has been done to suggest it might help patients in the intensive care unit reach a better recovery if they receive blood transfusions that are younger than this. This project will test whether patients who receive ‘fresher’ blood do better than patients who receive ‘standard issue ’ blood.
Re-EValuating The Inhibition Of Stress Erosions (REVISE): Gastrointestinal Bleeding Prophylaxis In ICU
Funder
National Health and Medical Research Council
Funding Amount
$2,955,164.00
Summary
Around 50,000 patients in Australian Intensive Care Units receive a drug called pantoprazole each year with the aim of preventing bleeding from the gut. Recent research suggests this practice is ineffective and may harm patients by increasing their risk of serious infections. We will perform a definitive study to determine whether the widespread use of pantoprazole is beneficial or harmful.